The Binding of Isaac: Afterbirth †/Additions

Mechanics

HUD

Found HUD

• Found HUD is a HUD addition that appears on the left side of the screen that gives numerical values to the player's current stats (e.g., damage, luck, speed, devil room chance). It can be enabled through the options menu.
• It is based on the Missing HUD mod for Rebirth and Afterbirth.

Victory Lap

• A Victory Lap allows you to start a new run with almost all of your final items after completing the Dark Room. Multiple laps can be made as long as the Dark Room is cleared each time.
  • Completion Marks and most achievements cannot be earned.
  • Isaac will take a full heart of damage on all floors after beginning a victory lap (unless he has The Wafer).
  • Some items are lost upon starting a victory lap. Items lost this way are added back into their respective item pools and can be acquired again.
  • If the initial run was on normal difficulty, all victory laps will be on hard difficulty.
  • On the third and subsequent victory laps, the character will turn into The Lost. This version of The Lost does not get a Holy Mantle or D4. However, if the run was started as The Lost (or if the Holy Mantle was found) it is possible to keep the Holy Mantle from the previous run.
  • On the third and subsequent victory laps, Shops will no longer appear.
  • On the third and subsequent victory laps, Red Chests in the Dark Room will turn into Chests and Locked Chests.
  • Killing any final boss aside from The Lamb will end the game, and the run will not be continued further.

Menus

Options

Charge bars

• Added a new "charge bars" option in the menu, for passive items that need to be charged up before usage.
• This includes:
  • Brimstone (collectible and Azazel)
  • Chocolate Milk
  • Cursed Eye
  • Lil Brimstone
  • Lil Delirium
  • Lil Gurdy
  • Lil Monstro
  • Maw Of The Void
  • Mom's Knife
  • Monstro's Lung
  • Tech X
  • Bone Club (The Forgotten's throwable weapon)

RERUN

• RERUN is unlocked after completing the RERUN achievement.
• After winning a run the Continue option in the main menu will be replaced by Rerun. Selecting it starts a new run using most of the previous won run's items. Isaac will take full heart damage on all floors.

Player

Characters

Character	Apollyon	The Forgotten
		The Forgotten	The Soul
Health
Damage	3.5 (*1.00)	3.50 (*1.50)	3.50 (*1.00)
Tears	+0	+0, x1/2	+0
Shot Speed	1	1	1
Range	23.75	23.75	23.75
Speed	1.0	1.00	1.30
Luck	0	0	0
Starting Pickups	None	None	None
Starting Item(s)	Void	Bone Club	Flight Spectral tears

Transformations

ID	Name	Appearance	Description
10	Bookworm		Roughly 25% of the time, Isaac shoots an extra tear, like 20/20.
11	Adult		+1 Red Heart container.
12	Spider Baby		Spawns a spider familiar that applies random status effects to enemies it comes in contact with.
13	Stompy		Taking damage has a chance to spawn rock waves. Isaac can break obstacles by walking over them.

Co-op

Special Babies

These Babies have special bonuses that will aid the player in some way.

ID	Appearance	Name	Description
55		Mort Baby	Spawns a blue fly, and spawns a new blue fly whenever its blue fly is destroyed. Defeat Mega Satan as Apollyon to unlock it. The sprite greatly resembles Rotten Baby.
56		Apollyon Baby	Spawns with two Pretty Flies. Earn all Hard mode Completion Marks as Apollyon to unlock it.
57		Bone Baby	Wields a melee bone club instead of shooting tears, similarly to The Forgotten. Earn all Hard mode Completion Marks as The Forgotten to unlock it.
58		Bound Baby	Is bound to Isaac, similarly to The Forgotten's soul. Shoots spectral tears. Defeat Mega Satan as The Forgotten to unlock it.

Normal Babies

These Babies are purely cosmetic and do not have any special behaviors.

ID	Appearance	Name	Description
428		Magiccat Baby	A baby that resembles the avatar of Tikara, the artist of the Isaac Tarot deck.
429		Little Horn Baby	A baby that resembles Little Horn.
430		Folder Baby	A baby with a folder for a head.
431		Driver Baby	A baby that is driving a car.
432		Dragon Baby	A baby that resembles a dragon.
433		Downwell Baby	A baby that resembles the player character from Downwell.
434		Cylinder Baby	A baby that is shaped like a cylinder.
435		Cup Baby	A baby with a teacup for a head.
436		Cave Robot Baby	A baby that resembles Quote from Cave Story.
437		Breadmeat Hoodiebread Baby	A toothy baby with a slice of toast for a head that resembles Breadmeat, a member of the Isaac community.
438		Bigmouth Baby	A baby with a large, wide-open mouth.
439		Afro Rainbow Baby	A baby with a rainbow colored afro.
440		Afro Baby	A baby with an afro.
441		TV Baby	A baby with a television for a head.
442		Tooth Baby	A baby with a tooth for a head.
443		Tired Baby	A tired-looking baby.
444		Steroids Baby	A muscular baby.
445		Soap Monster Baby	A baby that resembles Balrog from Cave Story.
446		Rojen Whitefox Baby	A baby that resembles a white fox. (might be a reference?)
447		Rocket Baby	A baby that looks like a firework.
448		Nurf Baby	A baby that resembles D.Va from Overwatch.
449		Mutated Fish Baby	A baby that resembles Fish from Nuclear Throne.
450		Moth Baby	A baby that resembles Moth from Creepy Castle.
451		Buttface Baby	A baby with a butt for a face.
452		Flying Candle Baby	A baby that looks like a candle.
453		Graven Baby	A baby with long hair. (might be a reference?)
454		Gizzy Chargeshot Baby	A baby that resembles Gizzy from ChargeShot.
455		Green Koopa Baby	A baby that resembles a green koopa from Mario.
456		Handsome MrFrog Baby	A baby that resembles Handsome Mr. Frog from the game of the same name.
457		Pumpkin Guy Baby	A baby with a pumpkin for a head wearing a purple rag. Possible reference to Terraria's Pumpking.
458		Red Koopa Baby	A baby that resembles a red koopa from Mario.
459		Sad Bunny Baby	A baby that looks like a crying rabbit. This is a reference to the sprites creator, Mort Mort (MnrArt) and their character Sad Bunny Face.
460		Saturn Baby	A baby that resembles the main character from Sgt. Saturn.
461		Toast Boy Baby	A baby with a slice of bread for a head. This is a reference to the sprite's creator, Mort Mort (MnrArt) and their character Toast Boy.
462		Voxdog Baby	A baby that resembles Vox the Dog.
463		404 Baby	A baby that has the Error trinket for a head.
464		Arrowhead Baby	A baby with an arrow through its head.
465		Beanie Baby	A baby wearing a green beanie.
466		Blindcursed Baby	A baby with the Curse of the Blind's question mark for a head.
467		Burning Baby	A baby that's been burnt to a crisp.
468		Cursor Baby	A baby that looks like a mouse cursor.
469		Flybaby	A baby that looks like a fly.
470		Headphone Baby	A baby wearing headphones.
471		Knife Baby	A baby with a knife for a head.
472		Mufflerscarf Baby	A baby wearing a scarf.
473		Robbermask Baby	A baby wearing a stereotypical robber's ski mask.
474		Scoreboard Baby	A baby with a digital number display, like those at a sporting event or on an alarm clock, for a face.
475		So Many Eyes Baby	A baby with eyes all over its body.
476		Text Baby	A baby made out of text characters. (ASCII art)
477		Wing Baby	A baby with wings.
480		Imp Baby	A baby that resembles the modded character Fiend from Devil's Harvest MOD.
481		32bit Baby	A baby that resembles Isaac in a 32 bit style.
482		Adventure Baby	A baby that resembles Finn the Human from Adventure Time.
483		Bubbles Baby	A baby made entirely of tar.
484		Bulb Baby	A baby that's very bright for his age.
485		Cool Orange Baby	A baby that resembles a very cool orange with sunglasses.
486		Crazy Ghost Baby	A baby that resembles Crazy Diamond from JoJo's Bizarre Adventure. (Also possibly a reference to the modded character.)
487		Cursed Pillow Baby	A baby that's unfortunately pillow shaded.
488		Egg Baby	A baby that resembles the modded item Greg the Egg.
489		Factory Baby	A baby that resembles a strange cyborg.
490		Falling Baby	A baby that resembles William Foster from Falling Down.
491		Funny Baby	A baby that resembles Sans from Undertale.
492		Gamer Baby	A baby that resembles an epic gamer. Inspired by a prominent member of the Binding of Isaac community.
493		Glittery Peach Baby	A baby resembling an oddly British Baby Plum.
494		Pompadour Baby	A baby that resembles Josuke from JoJo's Bizarre Adventure. (Also possibly a reference to the modded character.)
495		Head Kick Baby	A baby that resembles the Facepunch Logo.
496		Horn Baby	A baby that resembles the modded character Chronos.
497		Ichor Baby	A baby that resembles Ichor beasts from the game Heckland.
498		Ill Baby	A baby that resembles the modded boss Mahalath.
499		Lazy Baby	A baby that resembles Garfield.
500		Mern Baby	Mern.
501		Necro Baby	A baby that resembles the Xenomorph from the Alien franchise.
502		Peeping Baby	A baby that resembles the modded boss The Peeping.
503		Penance Baby	A baby that resembles the modded character Sarah from Revelations.
504		Psychic Baby	A baby that resembles the modded character Mei.
505		Puppet Baby	A baby that resembles the costume for the modded item Pinhead from Happy Items Pack.
506		Reaper Baby	A baby that resembles the modded character Samael.
507		Road Kill Baby	A baby that got ran over.
508		Sausage Lover Baby	A baby that resembles _Kilburn, the lead developer for Antibirth.
509		Scribble Baby	A baby that resembles the modded character The Drawn.
510		Star Plant Baby	A baby that resembles the main character from Germination.
511		Twitchy Baby	A baby that resembles Twitch from Heckland.
512		Witch Baby	A baby that resembles the modded character Endor from Alphabirth.
513		Workshop Baby	A baby that references a common trope of workshop thumbnails when firing tears.
514		Hooligan Baby	A baby that resembles Čeda from LeatherIceCream's "Poor 4" animations.
515		Half Spider Baby	A baby that resembles Miroslav from LeatherIceCream's "Poor 4" animations.
516		Silly Baby	A baby that resembles Djole from LeatherIceCream's "Poor 4" animations.
517		Master Cook Baby	A baby that resembles Andre from LeatherIceCream's "Poor 4" animations.
518		Green Pepper Baby	A baby that resembles one of _Kilburn's characters.
519		Baggy Cap Baby	A baby that resembles one of _Kilburn's characters.
520		Stylish Baby	A baby resembling the character Ren from the currently unreleased game Shenanigans: World of Illusions.

Items

109 new items were added in the expansion: 29 activated items and 80 passive items.

Activated Collectibles

Name	ID	Icon	Quote	Description	Quality
Black Hole	5.100.512		Nothing can escape	Throws a black hole on the ground which sucks in and damages enemies.	1
Book of the Dead	5.100.545		Rise from the grave	Creates a friendly Bony, Black Bony, or an orbital bone for each enemy killed in the current room. Creates a friendly Bony, Black Bony, Bone Fly, Revenant, or an orbital bone for each enemy killed in the current room.	3
Broken Shovel	5.100.550		It feels cursed	While held, causes Mom to continuously attempt to stomp on Isaac. Activating makes her stop for the current room or wave. One of two parts necessary to create Mom's Shovel.	4
Brown Nugget	5.100.504		Friendly fly	Spawns a stationary fly turret that lasts for the current room and fires tears at nearby enemies.	0
Clicker	5.100.482		Change	Transforms Isaac into a random character and removes the last item collected.	0
Compost	5.100.480		Gain more friends!	Doubles Isaac's Blue Flies and Blue Spiders, or spawns one if Isaac has none. Converts pickups in the current room into Blue Flies or Blue Spiders.	1
Coupon	5.100.521		Allow 6 weeks for delivery	While held, guarantees one item in every Shop will be on sale. On use, makes a random item in the current room free.	2
Crooked Penny	5.100.485		50/50	Spawns a penny and has a 50% chance to double all items and pickups in the room. If the effect fails, the items and pickups disappear.	2
D infinity	5.100.489		Reroll forever	Grants a random die item that changes each use. Acts as any die item, and can by cycled by pressing the drop key.	4
D1	5.100.476		What will it be?	Duplicates a random pickup in the room. The new pickup may be different than the original (i.e. a different card, etc).	2
Dataminer	5.100.481		109	Displaces enemy sprites for the current room, randomly increases one stat and decreases another.	0
Delirious	5.100.510		Unleash the power!	Spawns Delirium as a random friendly boss that fights for Isaac.	1
Dull Razor	5.100.486		I feel numb...	Hurts Isaac without depleting health, activating any items that trigger upon taking damage.	1
Eden's Soul	5.100.490		...	Spawns two item pedestals then is consumed. Begins with no charges.	3
Mama Mega!	5.100.483		BOOOOOOOOOM!	Damages all enemies and destroys all obstacles. The effect occurs every time a new room is entered for the rest of the floor. Opens the doors to the floor's Secret Rooms and Super Secret Rooms.	3
Metronome	5.100.488		Waggles a finger	Grants a random item effect for the current room.	1
Mom's Shovel	5.100.552		Lost but not forgotten	Creates a trapdoor that leads to the next floor upon activation. Unlocks The Forgotten when used on a mound of dirt that appears in Dark Room.	4
Moving Box	5.100.523		Pack and unpack	If the box is empty, picks up items and pickups in a room and stores them. If the box is not empty, places all stored items and pickups in the current room. Can carry up to 10 items or pickups at once.	1
Mr. ME!	5.100.527		Caaan do!	Summons a controllable ghost that can perform various tasks depending on what it targets.	3
Mystery Gift	5.100.515		Wrapped up nice for you!	Upon use, spawns a random item from the current room's item pool, with a chance to spawn A Lump of Coal or The Poop instead.	3
Pause	5.100.478		Stop!	Freezes all enemies until a fire button is pressed.	1
Plan C	5.100.475		My last resort	Kills all enemies in the room, then kills Isaac three seconds later.	0
Potato Peeler	5.100.487		A pound of flesh	Removes a Heart Container, increases damage and range, and grants a Cube of Meat.	2
Sacrificial Altar	5.100.536		He demands a sacrifice	Sacrifices up to 2 familiars and spawns an item for each familiar sacrificed. Converts all friendly spiders and flies into coins.	2
Sharp Straw	5.100.507		More blood!	Damages all enemies in the room. Has a chance to drop a Half Red Heart or Half Soul Heart if an enemy is hit. Damages all enemies in the room. Has a chance to drop a Half Red Heart if an enemy is hit.	2
Smelter	5.100.479		Trinket melter!	Consumes Isaac's currently held trinket and applies its effect permanently.	2
Sprinkler	5.100.516		Sprinkles.	Upon use, creates a stationary sprinkler that rotates and fires tears in 8 directions. The tears copy Isaac's stats and most tear effects.	2
Telekinesis	5.100.522		Power of the mind	Upon use, for the next three seconds, any enemy shots that come near Isaac are held in place and then later reflected.	1
Void	5.100.477		Consume	Consumes all pedestal items in the room. Active items will have their effects added to Void, and passive items will grant random stat upgrades.	4
Wait What?	5.100.484		I can't believe it's not butter bean!	Isaac farts, sending out rock waves.	1

Passive Collectibles

Name	ID	Icon	Quote	Description	Quality
7 Seals	5.100.526		Lil harbingers!	Spawns a random Harbinger familiar that changes every 10 seconds. Harbingers have different behaviors and spawn themed Locusts.	2
Acid Baby	5.100.491		Pills pills pills!	Spawns a familiar that drops a random pill every 3 rooms. Upon using a pill, all enemies in the room are poisoned.	2
Adrenaline	5.100.493		Panic = power	Increases damage based on how many empty Red Heart containers Isaac has.	2
Analog Stick	5.100.465		360 tears!	+0.35 tears up. Allows Isaac to fire tears diagonally.	2
Angelic Prism	5.100.528		Eclipsed by the moon	Spawns an orbital familiar with a large orbital radius. Tears that pass through the prism split into four multi-colored tears.	3
Angry Fly	5.100.511		He's violent	Spawns a fly familiar that orbits around a random enemy and deals 30 damage per second to enemies it comes in contact with.	1
Apple!	5.100.443		Trick or treat?	+0.3 tears. Adds a chance to fire a razor blade that deals 4x Isaac's damage.	3
Backstabber	5.100.506		Watch your back!	Isaac's tears deal double damage and inflict bleeding on enemies if they're facing away from Isaac.	3
Belly Button	5.100.458		What's in there?	Drops a random trinket. Grants a second trinket slot.	2
Big Chubby	5.100.473		Chub chub	Spawns a familiar that follows Isaac and charges across the room when Isaac fires, blocking shots and dealing 40.5 damage per second on contact.	1
Blanket	5.100.535		You feel Safe	Grants one Soul Heart. Upon entering a boss room, grants a shield that blocks one hit, then disappears.	2
Bloodshot Eye	5.100.509		Bloody friend	Spawns an orbital familiar that deals 30 damage per second and fires a randomly angled tear every 2 seconds.	1
Bozo	5.100.513		Party time!	+0.1 flat damage, grants a Soul Heart. Enemies can randomly become briefly charmed or feared. Taking damage has a chance to spawn a Rainbow Poop.	2
Brittle Bones	5.100.549		Everything hurts	Replaces all Red Heart Containers with 6 empty Bone Hearts. Upon losing a Bone Heart, Isaac fires bones in 8 directions and permanently gains a tears up. Upon losing a Bone Heart, Isaac fires bones in 8 directions and permanently gains a fire rate up.	3
Broken Modem	5.100.514		Lag!	Enemies, enemy shots, tears, and pickups will briefly freeze in place at random intervals.	3
Broken Shovel	5.100.551		It feels cursed	One of two parts necessary to create Mom's Shovel. No effect if somehow obtained on its own.	4
Buddy in a Box	5.100.518		What could it be?!	Spawns a familiar with a random tear effect. The familiar is randomized at the start of each floor.	2
Camo Undies	5.100.497		Camo kid	Isaac becomes camouflaged at the beginning of each room. Until he shoots, all non-boss enemies will be confused. Isaac gains +0.5 Speed while camouflaged, and gains Tears and Damage upon breaking it.	3
Compound Fracture	5.100.453		Bone tears!	Increases Range. Tears turn into bones, which shatter into 1-3 bone shards upon hitting an enemy or obstacle.	3
Cone Head	5.100.457		Hard headed!	Grants a Soul Heart. Gives Isaac a chance to ignore any damage taken.	2
Contagion	5.100.466		Outbreak!	The first enemy killed in a room releases a gas cloud that poisons nearby enemies. Affected enemies will also release gas upon death, spreading the effect.	2
Dad's Lost Coin	5.100.455		I remember this...	+1.5 range, +1 tear falling speed. Drops a Lucky Penny. +2.5 range. Drops a Lucky Penny.	1
Dad's Ring	5.100.546		Father's blessing	Creates a ring of light around Isaac that petrifies enemies in contact.	3
Dark Prince's Crown	5.100.442		Loss is power	When at exactly one Red Heart, increases tears, range, tear falling speed, and shot speed. When at exactly one Red Heart, increases fire rate, range, and shot speed.	1
Dead Tooth	5.100.446		Toxic breath	While firing, Isaac gains a green aura that poisons nearby enemies.	1
Death's List	5.100.530		Just hope you're not next...	Grants a pickup or stat upgrade if all enemies in a room are killed in the order they are marked.	2
Depression	5.100.469		:(	Spawns a familiar that leaves a trail of creep that damages enemies at 6 damage per second. Has a chance to spawn damaging beams of light onto enemies that touch the cloud.	1
Divorce Papers	5.100.547		Tears up + you feel empty	Grants one Bone Heart, +0.7 tears, spawns a Mysterious Paper.	3
Dog Tooth	5.100.445		Bark at the moon!	+0.3 damage, +0.1 speed. Plays a howl or bark sound when entering a room with undiscovered Secret Rooms or Crawl Spaces.	2
Duality	5.100.498		You feel very balanced	Whenever a Devil Room or Angel Room would spawn after defeating a boss, both rooms spawn. Only one can be entered.	1
Eucharist	5.100.499		Peace be with you	An Angel Room door will always spawn after every boss fight, excluding the first floor and floors after Womb II/Utero II/Scarred Womb II.	3
Euthanasia	5.100.496		Needle shot	Adds a chance to fire needles that instantly kill basic enemies and deal triple damage to bosses. If a needle kills an enemy, it bursts into more tears/needles.	3
Eye of Belial	5.100.462		Possessed tears!	Grants piercing tears. After piercing one enemy, tears start homing and deal double damage.	3
Eye of Greed	5.100.450		Gold tears!	Every 20 tears, Isaac loses 1 Penny and shoots an additional gold tear that petrifies enemies and turns them into gold. Any enemy killed while in this state will drop coins.	2
Fast Bombs	5.100.517		Rapid bomb drops	+7 Bombs. Removes the delay between bomb placements, allowing them to be placed rapidly. Bombs will no longer knock each other away.	1
Finger!	5.100.467		Watch where you point that!	Spawns a finger familiar that faces in the same direction as Isaac, rapidly damaging enemies it points at for 10% of Isaac's damage.	1
Flat Stone	5.100.540		Skipping tears	Tears bounce off the floor, creating splashes. Splashes deal 25% of Isaac's tear damage to all enemies in a small area.	2
Ghost Pepper	5.100.495		Flame tears	Gives a chance to shoot fires alongside tears that block enemy shots and deal damage to enemies that touch them. Gives a chance to shoot blue fires alongside tears that become smaller as they travel.	3
Glaucoma	5.100.460		Blind tears!	Adds a chance to shoot tears that confuse enemies for an extremely long time.	1
Glyph of Balance	5.100.464		A gift from above	Grants 2 Soul Hearts and modifies drops from Champion monsters based on certain conditions. Also modifies room clear drops.	2
Greed's Gullet	5.100.501		Money = health!	Grants a Red Heart container for every 25 Coins Isaac has.	1
Haemolacria	5.100.531		I'm seeing red...	Tears are now fired in an arc. Upon hitting the floor, an obstacle, or an enemy, they burst into many smaller tears in all directions. Increases tear delay.	4
Hallowed Ground	5.100.543		Portable sanctuary	Spawns a white poop familiar, which turns into a White Poop when Isaac is hurt. White poop has an aura that increases tear fire rate and can block enemy shots. The aura also increases damage by 20% and gives homing.	1
Hushy	5.100.470		Lil hush!	Spawns a Hush familiar that bounces diagonally around the room and deals contact damage. While firing tears, it stops moving.	0
Jacob's Ladder	5.100.494		Electric tears	Tears fire sparks of electricity in random directions upon hitting an obstacle or enemy.	3
Jaw Bone	5.100.548		Fetch!	Spawns a familiar that flies through the room while firing, dealing a flat 7 contact damage to enemies and retrieving pickups.	1
Jumper Cables	5.100.520		Bloody recharge	Grants an active item charge every 15 enemies killed.	3
King Baby	5.100.472		Hail to the king baby	Spawns a familiar that follows Isaac and makes other familiars follow it. While firing tears, other familiars stop moving.	1
Lachryphagy	5.100.532		Feed them!	Isaac's tears decelerate as they travel. Upon stopping or hitting an obstacle, they burst into 8 tears in all directions. Tears can be fired into other tears to feed them, increasing their damage.	2
Large Zit	5.100.502		Creep shots	Adds a chance to fire a creep shot that deals double damage and leaves a trail of slowing white creep.	1
Lead Pencil	5.100.444		He's a bleeder!	After every 15 tears fired, Isaac will fire a high-damage cluster of tears.	3
Leprosy	5.100.525		You're tearing me apart!	Upon taking damage, grants a body part as an orbital, which blocks enemy shots and deals 7 damage per tick to enemies it comes in contact with. The orbitals will be destroyed if they take enough damage from enemies or enemy shots.	1
Lil Delirium	5.100.519		Delirious friend	Grants a familiar that transforms into another random familiar every 10 seconds.	2
Lil Monstro	5.100.471		Ain't he cute?	Spawns a familiar that fires clusters of tears. Must be charged before shooting.	2
Lil Spewer	5.100.537		Puking buddy	Drops a random pill, and spawns a familiar that charges up and fires creep. Using pills changes the creep type.	1
Linger Bean	5.100.447		Crying makes me toot	Constantly shooting causes Isaac to release gas clouds that can be pushed by his tears and damage nearby enemies.	0
Little Horn	5.100.503		Big brother is watching	Adds a chance to fire a piercing tear that instantly kills any enemy that it touches. Adds a chance to fire a tear that summons Big Horn's hand to crush the first enemy it hits, instantly killing monsters or greatly damaging bosses.	3
Marbles	5.100.538		Choking hazard	Spawns 3 random trinkets. Taking damage has a 5% chance to swallow Isaac's currently held trinket, gaining its effect permanently.	2
Marrow	5.100.541		HP up?	Grants one Bone Heart and spawns three Red Hearts.	1
Metal Plate	5.100.449		It itches...	Grants one Soul Heart. Enemy shots have a chance to be reflected at the shooter as confusing tears.	1
Midnight Snack	5.100.456		HP up	Grants one full Red Heart container. Heals 1 additional Red Heart.	1
Mom's Razor	5.100.508		It's sharp!	Spawns an orbiting razor that deals contact damage and inflicts bleeding on enemies, causing them to slowly take damage over time.	2
Mystery Egg	5.100.539		Sacrificial insemination	Spawns an egg familiar, which hatches a random friendly monster when Isaac is hurt once per room. The power of the monster improves for each consecutive room cleared without taking damage.	1
Parasitoid	5.100.461		Egg tears!	Adds a chance to fire an egg sack which creates slowing creep and spawns a Blue Fly or Blue Spider upon hitting an enemy.	3
Pointy Rib	5.100.544		Stabbing time	Spawns a bone familiar that hovers back and forth in front of Isaac, dealing damage equal to Isaac's damage.	2
Poke Go	5.100.505		Gotta catch em...	Upon entering a room with enemies in it, has a chance to spawn a random friendly enemy that persists across rooms.	2
Polydactyly	5.100.454		Hold me!	Allows Isaac to carry two cards, pills, or any combination of both. Spawns one random card, rune, or pill.	2
Pop!	5.100.529		Eyeball tears!	Replaces Isaac's tears with eyeballs that can bounce off of each other. The eyeballs are not limited by range, and will instead dissipate when they stop moving or when hitting an enemy or obstacle.	1
Sack of Sacks	5.100.500		Gives sacks	Spawns a familiar that drops a Grab Bag every 5-6 rooms cleared.	3
Schoolbag	5.100.534		Extra active item room	Allows Isaac to hold two active items.	3
Shade	5.100.468		It follows	Spawns a shadow familiar that follows Isaac's movements on a 1 second delay and deals contact damage to enemies. After dealing enough damage, it is absorbed by Isaac and spawns friendly Chargers.	0
Shard of Glass	5.100.448		Blood and guts!	Upon taking damage, Isaac has a chance to drop a full red heart, gain 5 range, and leave a trail of damaging red creep for the current room. Taking damage causes Isaac to bleed, spraying a volley of blood in the direction he fires. Bleeding will eventually damage him, but it can be stopped by picking up a Red Heart.	1
Sinus Infection	5.100.459		Booger tears!	Adds a chance to fire a booger that sticks to enemies and deals damage over time.	3
Slipped Rib	5.100.542		Projectile shield	Spawns a bone familiar that circles around Isaac and reflects enemy shots.	2
Sulfuric Acid	5.100.463		Acid tears!	+0.3 damage. Adds a chance to fire acidic tears which can destroy obstacles and open doors.	2
Tarot Cloth	5.100.451		I see the future	Drops a random card or rune. Doubles the effects of most cards and runes. Doubles the effects of tarot cards.	2
Technology Zero	5.100.524		Static tears!	Connects Isaac's tears with electricity that can damage enemies.	3
Trisagion	5.100.533		Smite thy enemy	Tears are replaced with piercing white blasts of light that deal less damage but can damage the same enemy multiple times.	3
Varicose Veins	5.100.452		I'm leaking...	Taking damage releases a ring of 10 high damage tears.	1
YO LISTEN!	5.100.492		Yo listen!	+1 luck. Spawns a fairy familiar that points out Secret Rooms, Crawl Space entrances, and tinted rocks.	2
Tonsil	5.100.474		Gross...	Grants a familiar that follows Isaac and blocks enemy shots.

Trinkets

38 new trinkets were added in the expansion.

Name	ID	Icon	Quote	Description
Baby-Bender	5.350.127		Feed them magic!	Grants Isaac's familiars homing shots.
Bag Lunch	5.350.105		I wonder what it is	Taking damage has a small chance to destroy the trinket and spawn Lunch.
Bat Wing	5.350.118		They are growing...	Upon killing an enemy, has a chance to grant flight for the rest of the room.
Black Tooth	5.350.95		It looks dead	Adds a chance to fire a black tooth that deals double damage and poisons enemies.
Bloody Crown	5.350.111		Drips with blood...	Treasure Rooms appear in chapter 4.
Butter!	5.350.122		Can't hold it!	Using an active item will drop it onto a pedestal on the ground. Taking damage may result in dropping a passive item.
Cracked Crown	5.350.92		Stat booster	Decreases Isaac's tear delay by 20%, and improves the effectiveness of his other stat upgrades by 33%. Improves the effectiveness of stat upgrades by 20%.
Crow Heart	5.350.107		Drain me	Red Heart damage will be taken before Soul Heart, Black Heart, and Rotten Heart damage.
Dim Bulb	5.350.101		I think it's broken	Provides a boost to all stats when Isaac's active item is completely uncharged.
Door Stop	5.350.124		Hold the door!	The last door Isaac went through stays open, allowing him to leave the room even if enemies are in it.
Duct Tape	5.350.109		Stuck!	Holds Isaac's familiars in place relative to his position.
Equality!	5.350.103		=	Turns pickups into their doubled versions while Isaac's numbers of coins, bombs, and keys are equal.
Extension Cord	5.350.125		Charged friends	Bolts of electricity arc between Isaac and his familiars, damaging any enemies between them.
Filigree Feather	5.350.123		Angelic spoils	Angels drop Angel Room items instead of key pieces when defeated.
Finger Bone	5.350.128		It looks brittle	Grants a chance to gain a Bone Heart upon taking damage.
Fish Tail	5.350.94		It also stinks!	Items and trinkets that generate Blue Flies or locusts will generate twice as many.
Fragmented Card	5.350.102		Double moon	Makes two Secret Rooms spawn on each floor.
Hairpin	5.350.120		Danger charge	Fully recharges Isaac's active item upon entering a boss fight.
Locust of Conquest	5.350.117		I bring Conquest	Upon entering a room with enemies, spawns 1-4 White Locusts which damage enemies.
Locust of Death	5.350.116		I bring Death	Upon entering a room with enemies, spawns a Black Locust that does a very high amount of damage.
Locust of Famine	5.350.115		I bring Famine	Upon entering a room with enemies, spawns a Yellow Locust that damages and slows enemies.
Locust of Pestilence	5.350.114		I bring Pestilence	Upon entering a room with enemies, spawns a Green Locust which damages and poisons enemies.
Locust of War	5.350.113		I bring War	Upon entering a room with enemies for the first time, spawns a Red Locust which detonates upon impact with enemies.
Lost Cork	5.350.106		Uncorked	Increases the radius of any creep produced by Isaac.
Meconium	5.350.91		Eww	Black Poops can drop Black Hearts when destroyed. Poop has a chance to turn into Black Poop.
Nose Goblin	5.350.98		Seems magic...	Chance to fire a homing booger that sticks to enemies and deals damage over time.
Ouroboros Worm	5.350.96		Foop foop!	Tears travel in a large spiral pattern and gain spectral, with a small chance to gain homing. Also adds +0.4 Tears.
Pay to Win	5.350.112		...	Shop Restock Machines always spawn in Treasure Rooms.
Rotten Penny	5.350.126		Wealth of flies	Spawns a Blue Fly every time a coin is picked up.
Silver Dollar	5.350.110		Feels lucky...	Shops appear in Chapter 4.
Stem Cell	5.350.119		Regen!	Heals Isaac for a Half Red Heart upon traveling to the next floor. Heals Isaac's Red Heart health to 50% of maximum upon traveling to the next floor. If his health is already equal to or above 50%, it heals half a Red Heart instead.
Super Ball	5.350.99		Boing!	Makes tears have a chance to bounce off enemies and obstacles.
Tonsil	5.350.97		Sick...	When hit, there is a small chance to spawn a permanent tonsil familiar that blocks enemy shots. This can happen twice, after which the trinket is destroyed.
Used Diaper	5.350.93		You stink	Grants the Skatole effect in some rooms.
Vibrant Bulb	5.350.100		It needs power	Provides a boost to all stats when Isaac's active item is fully charged.
Walnut	5.350.108		That's a hard nut to crack!	Being hit by explosions will eventually destroy the trinket and spawn various pickups.
Wish Bone	5.350.104		Make a wish	Taking damage has a small chance to destroy the trinket and spawn a random item.
Wooden Cross	5.350.121		My faith protects me	Grants a shield that negates the first damage taken once per floor.

Pickups

Hearts

Heart	ID	Image	Worth	Additional Info	Unlocked By
Scared Heart	9			Identical to the standard Red Heart, but will run away as the player moves towards it. Heals with Maggy's Bow. Humbleing Bundle and Equality! will not double this.
Half Soul Heart	8				Reset 7 times in a row Switch PS4 Get a minus 10-win streak
Blended Heart	10		//	Fills up a full red Heart Container, but will act as a Soul Heart when no Containers are free. If Isaac is only missing half a Red Heart, it will fill that half, and give him half a soul heart as well. Dark Bum and The Jar will not collect this.
Bone Heart	11			Takes three hits to deplete and can be refilled with red hearts, but disappears permanently upon depleting.	It's complicated

Keys

Key	ID	Image	Worth	Additional Info	Unlocked By
Charged Key	4		1	Fully charges your currently held active item upon pickup. Key Bum will pick this up, but will not give Isaac any active charge.	Complete Pokey Mans (challenge #33)

Pills

ID	Pill	Effect
39	X-Lax	Creates a pool of slippery brown creep underneath Isaac.
40	Something's wrong...	Creates a pool of black creep beneath Isaac.
41	I'm Drowsy...	Upon use, slows all enemies for the duration of the room.
42	I'm Excited!!!	Upon use, increases the speed of all enemies for the duration of the room. The effect triggers again 30 seconds after use and 60 seconds after use.
43	Gulp!	Upon use, any trinkets that the player is holding are destroyed, and their effects are permanently applied to the player. Unlocked by acquiring the Once More With Feeling! achievement.
44	Horf!	Upon use, Isaac shoots an explosive tear with the Ipecac effect that always deals 200 damage. Unlocked by acquiring the Dedication achievement.
45	Feels like I'm walking on sunshine!	Temporarily makes Isaac invincible, similar to Unicorn Stump. Unlocked by acquiring the Sin Collector achievement.
46	Vurp!	Throws up the last pill you used. Will spawn itself if no other pills were taken beforehand. Unlocked by acquiring the U Broke It! achievement.

Cards

Name	ID	Icon	Message	Description
Ace of Clubs	5.300.27		Convert all	Turns all Pickups, Chests, and non-boss enemies in the room into random Bomb pickups, including Troll Bombs.
Ace of Diamonds	5.300.28		Convert all	Turns all Pickups, Chests, and non-boss enemies in the room into random Coin pickups.
Ace of Spades	5.300.29		Convert all	Turns all Pickups, Chests, and non-boss enemies in the room into random Key pickups.
Ace of Hearts	5.300.30		Convert all	Turns all Pickups, Chests, and non-boss enemies in the room into random Hearts.
Holy Card	5.300.51		You feel protected	Grants a one-time Holy Mantle effect. It lasts for the current room.
Huge Growth	5.300.52		Become immense!	For the current room, makes Isaac larger, allows him to crush obstacles he walks on, and grants +7 flat Damage and +30 Range. For the current room, makes Isaac larger, allows him to crush obstacles he walks on, and grants +7 flat Damage and +3 Range.
Ancient Recall	5.300.53		Draw 3 cards	Spawns 3 random cards.
Era Walk	5.300.54		Savor the moment	For the current room, enemies are slowed, Isaac's speed is increased by 0.50, and his shot speed is decreased by 1.00.

Runes

Name	ID	Icon	Message	Description
Black Rune	5.300.41		Void	Deals 40 damage to all enemies in the room. Consumes all pickups in the room and turns them into Blue Flies and Spiders. Consumes all pedestal items in the room and turns them into random stat upgrades. No effect on Shop or Devil Room items. (Essentially, activates The Necronomicon, Compost, and Void).

Chests

Mimic Chests

• Mimic Chests appear similar to Brown Chests until Isaac moves near, at which point they sprout spikes that damage the player as a Spike Chest would. They can be distinguished from Brown Chests by their darker, purplish-brown coloring, the grayish spot on each side of the latch where the spikes will sprout from and the bloodstain.

Entities

Monsters

Entity	ID	Description
Blended Heart	5.10.10	{{{behavior}}}
Bone Heart	5.10.11	{{{behavior}}}
Half Soul Heart	5.10.8	{{{behavior}}}
Scared Heart	5.10.9	{{{behavior}}}
Charged Key	5.30.4	{{{behavior}}}
Mimic Chest	5.54	{{{behavior}}}
Dank Charger	23.2	Slowly moves around the room, launching itself at Isaac if he gets in its line of sight. Bounces off of walls and leaves a trail of slowing Black Creep while charging.
Mr. Red Maw	35.2	Walks towards Isaac and attacks by launching its head towards him. Turns into a Red Maw or Gusher upon death depending on the killed body segment. Occasionally separates at will.
Soul Sucker	61.2	Flies slowly towards Isaac. Spawns a vortex that fires four Brimstone beams in the cardinal directions upon death.
Cross Stone Shooter	202.10	Stationary and invulnerable monster that continuously fires shots in four directions, alternating between cardinal and ordinal.
Crispy	226.2	Slowly walks towards Isaac, but increases in speed as they take damage. Constantly passively takes damage.
Nerve Ending 2	231.1	Static enemy which whips at Isaac if he gets too close.
Tube Worm	244.1	Pops out of the ground in random locations and fires a long-range spray of arcing shots where Isaac will be.
White Poop	245.4	{{{behavior}}}
Mushroom	300.0	Stationary enemy that occasionally pops up and fires four shots in the cardinal or diagonal directions. Takes less damage while its head is down.
Poison Mind	301.0	Slowly crawls/floats around the room diagonally, leaving a trail of damaging green creep. Explodes upon death.
Stoney	302.0	Chases Isaac and blocks tears, but does not deal contact damage. Temporarily pauses in exhaustion after a certain amount of time. Invulnerable; dies when the room is cleared.
Cross Stoney	302.10	Chases Isaac and shoots 4 tears vertically and diagonally like a Cross Stone Shooter. Dies when the room is cleared. Only appears in Aprils Fool (challenge #32) as replacements to regular Stoneys.
Blister	303.0	Slowly hops towards Isaac, occasionally spawning a Dark Ball. Spawns a Sack upon death.
The Thing	304.0	Crawls along a wall and attempts to line up with Isaac, then spits a line of damaging Red Creep.
Ministro	305.0	Hops around randomly and hop towards Isaac when he gets close, occasionally spitting out a cluster of disorganized shots.
Portal	306.0	Spawns various enemies from the current floor until it either vanishes or is killed.
Tar Boy	307.0	Fires a short-ranged spray of shots that leave behind slowing Black Creep. Occasionally burrows underground and reappears under any pools of black creep in the room. If Isaac stands on the Creep, the Tar Boy can fire shots straight upwards out of the Creep underneath Isaac/ send out a tentacle underneath Isaac.
Fistuloid	308.0	Flies towards Isaac in an erratic waving motion, periodically firing a blood shot towards Isaac that also knocks itself back. Upon death, fires a worm that flies off screen.
Gush	309.0	Stationary, harmless enemy that continually creates slowing black creep.
Leper	310.0	Alternating between walking towards and running away from Isaac. Releases a Leper Flesh each time it takes enough damage. At low health, constantly chases Isaac and leaves behind damaging red creep. Spawns a Leper Flesh and Gusher upon death.
Leper Flesh	310.1	Floats slowly toward Isaac and fires a predictive projectile at him upon death.
Mr. Mine	311.0	Can only appear in pits. Attempts to launch itself at Isaac if he comes near. Occasionally burrows and pops up in another pit, and fires six shots in all directions upon death.
Purple Ball	409.1	Floats towards Isaac, doing contact damage.

Bosses

5 bosses were added in Afterbirth †. Additionally, Ultra Greed received a second form in Greed Mode's hard mode.

Rag Mega	Big Horn	Sisters Vis	The Matriarch

Delirium	Ultra Greedier

Environment

Chapters

The Void

Obstacles

Super special rock

• Super special rocks are tinted rock variants which are much harder to spot, as they have a smaller mark and are not discolored. Super special rocks takes two bombs to blow up, and drop the contents of two tinted rocks.

White poop

• White poop is surrounded by an aura that halves tear delay and has a high chance to block damage like the Cone Head item while Isaac stands within it. The aura disappears if the poop is destroyed.

Dirt Patch

• Dirt Patches are a small mound of dirt that can be dug into with certain items. Using Mom's Shovel on top of a Dirt Patch will reveal a skeleton and unlock The Forgotten. Once The Forgotten is unlocked, using Mom's Shovel, We Need To Go Deeper!, or Rune of Ehwaz on top of a Dirt Patch will dig up a random chest.

Machines

Mom's Dressing Table

• It appears in the starting room of a floor if Isaac has 8 or more items.
• If Isaac bumps into Mom's Dressing Table, his appearance will be randomly changed so that only a few of his items are displayed.
• Hitting Mom's Dressing Table with an explosive will cause it to vanish and drop 1-4 pills. There is a 1% chance to spawn one of the following items instead: Mom's Underwear, Mom's Heels, Mom's Lipstick, Mom's Bra, Mom's Pad, Mom's Eyeshadow, Mom's Contacts, Mom's Wig, Mom's Perfume or Mom's Pearls.

Challenges

Name	Conditions	Goal	Unlocked by	Unlocks
31. Backasswards	Starts with: 8-10 random items : no : yes All chapters progress in reverse order, losing 1 item and 1 Red Heart container each floor ascended.	Basement/Cellar/Burning Basement I	Defeat ??? or The Lamb Defeat Mega Satan and unlock The Negative	Laz Bleeds More!
32. Aprils Fool	: yes : yes The minimap displays the floor's layout accurately but displays Isaac's position inaccurately. Pedestal items and pickups are not what they appear to be. Active items, pills, cards, and rune effects are randomized upon each use, making them very unreliable or deadly (for example Suicide King). Items with no charge time (i.e. How to Jump, IV Bag, etc) can be used repeatedly for random effects. Stonies have a chance of being replaced by a Cross Stoney. Every boss is The Bloat. Isaac's health is not what it appears to be. Inventory pickups numbers are accurate.		Defeat Mom	Maggy Now Holds a Pill!
33. Pokey Mans	Starts with: [[{{{page}}}|Friendly Ball]] [[{{{page}}}|Mom's Eyeshadow]] : no : yes Each use of Friendly Ball causes a random monster to be spawned. Friendly Ball instantly charges once the spawned monster is killed.		Defeat Mom's Heart 11 times	Charged Key
34. Ultra Hard	Starts with: [[{{{page}}}|Key Piece 1]] [[{{{page}}}|Key Piece 2]] Curse of the Labyrinth Curse of the Blind Curse of the Lost Curse of the Maze : yes : yes All enemies spawn as champions if possible. Boss fights will be double trouble if possible. No heart pickups drop.		Defeat ??? or The Lamb. Possession of The Polaroid / The Negative is required, barring getting to Dark Room through a Sacrifice Room. Defeat Mega Satan and unlock The Negative	Samson Feels Healthy!
35. Pong	Starts with: Cupid's Arrow Rubber Cement : no : yes Damage fixed at 100, tear delay fixed at 150.		Defeat Isaac 5 times	Greed's Gullet

Achievements

Name	Image	Description	Unlock	In Game Secret Number
1000000%		Just Stop!	Collect every item in the game, unlock all secrets and endings, and complete the Bestiary	339
5 Nights at Mom's		Unlocked super special rocks.	Get a 5-win streak, using a different character each time ( this number can be reduced to 3, see the notes section)	323
7 Seals		Unlocked a new item.	Defeat all 5 Harbingers	372
Ancient Recall		Unlocked a new item.	Use Cards and Runes 20 times	362
Angelic Prism		Unlocked a new item.	Defeat an Angel 10 times	373
Angry Fly		Unlocked a new item.	Become Beelzebub	352
Apollyon		Unlocked a new character.	Defeat Mega Satan	340
Apollyon Baby		Unlocked a new co-player baby.	Earn all Hard mode Completion Marks as Apollyon	319
Aprils fool		Unlocked a new challenge.	Defeat Mom	278
Baby-Bender		Unlocked a new item.	Use I - The Magician or Telepathy For Dummies while already having homing tears	389
Backasswards		Unlocked a new challenge.	Defeat ??? or The Lamb Defeat Mega Satan and unlock The Negative	277
Bat Wing		Unlocked a new item.	Defeat Ultra Greedier as Azazel	304
Black Hole		Unlocked a new item.	Defeat 20 Portals	349
Black Rune		Unlocked a new item.	Defeat Ultra Greedier as Apollyon	309
Blanket		Unlocked a new item.	Sleep in 10 beds	385
Bloody Crown		Unlocked a new item.	Defeat Delirium as Samson	287
Bone Baby		Unlocked a new co-player baby.	Earn all Hard mode Completion Marks as The Forgotten	402
Bone Heart		Unlocked a new item.	It's complicated	391
Book of the Dead		Unlocked a new item.	Defeat Delirium as The Forgotten	401
Bound Baby		Unlocked a new co-player baby.	Defeat Mega Satan as The Forgotten	403
Bozo		Unlocked a new item.	Destroy 5 rainbow poops	353
Brittle Bones		Unlocked a new item.	Defeat The Lamb as The Forgotten	396
Broken Modem		Unlocked a new item.	Complete 7 Daily Challenges (by touching the trophy at the end)	354
Brown Nugget		Unlocked a new item.	Defeat Ultra Greed as Apollyon	316
Buddy in a Box		Unlocked a new item.	Pick up 5 familiars in a single run	355
Burning Basement		Alt stage to the basement.	Defeat Mom's Heart 11 times	342
Butter!		Unlocked a new item.	Complete 2 Victory Laps and start a 3rd	360
Charged Key		Unlocked a new item.	Complete Pokey Mans (challenge #33)	333
Compound Fracture		Unlocked a new item.	Defeat Delirium as Lazarus	291
Coupon		Unlocked a new item.	Purchase anything from Shops, Devil Rooms, and/or Black Markets 50 times	364
Crooked Penny		Unlocked a new item.	Defeat Delirium as Keeper	294
Crow Heart		Unlocked a new item.	Defeat Ultra Greedier as Eve	302
D infinity		Unlocked a new item.	Defeat Delirium as Isaac	282
D1		Unlocked a new item.	Defeat Ultra Greedier as Isaac	296
Dad's Lost Coin		Unlocked a new item.	Defeat Ultra Greedier as The Lost	307
Dad's Ring		Unlocked a new item.	Defeat Ultra Greedier as The Forgotten	400
Dank Depths		Alt stage to the depths.	Defeat It Lives! 21 times	344
Dark Prince's Crown		Unlocked a new item.	Defeat Delirium as Azazel	290
Death's List		Unlocked a new item.	Take 25 Deals with the Devil	376
Dedication		Unlocked a new item.	Participate in 31 Daily Challenges (they don't have to be consecutive; it will still count if Isaac dies in the first room)	325
Delirious		Unlocked a new item.	Defeat Delirium	338
Divorce Papers		Unlocked a new item.	Complete the Boss Rush as The Forgotten	397
Door Stop		Unlocked a new item.	Blow up doors and Secret Room walls 50 times	375
Duality		Unlocked a new item.	Defeat Ultra Greedier as Lilith	306
Dull Razor		Unlocked a new item.	Defeat Delirium as Eve	288
Eden's Soul		Unlocked a new item.	Defeat Delirium as Eden	289
Era Walk		Unlocked a new item.	Add both the Broken Watch and the Stop Watch to your collection	363
Eucharist		Unlocked a new item.	Defeat Delirium as Magdalene	283
Euthanasia		Unlocked a new item.	Defeat Delirium as Lilith	292
Extension Cord		Unlocked a new item.	Have The Battery, 9 Volt, and Car Battery in Isaac's collection	381
Eye of Belial		Unlocked a new item.	Defeat Ultra Greedier as Judas	299
Eye of Greed		Unlocked a new item.	Defeat Ultra Greedier as Keeper	308
Fast Bombs		Unlocked a new item.	Defeat Little Horn 20 times	356
Filigree Feather		Unlocked a new item.	Acquire both Key Piece 1 and Key Piece 2	370
Finger Bone		Unlocked a new item.	Defeat Ultra Greed as The Forgotten	399
Flat Stone		Unlocked a new item.	Acquire Rubber Cement 5 times	382
Flooded Caves		Alt stage to the caves.	Defeat It Lives! 16 times	343
Glyph of Balance		Unlocked a new item.	Defeat Ultra Greedier as Magdalene	297
Greed's Gullet		Unlocked a new item.	Complete Pong (challenge #35)	335
Greedier!		New mode unlocked!	Donate 500 Coins to the Greed Donation Machine	341
Haemolacria		Unlocked a new item.	Acquire Blood Clot 10 times	377
Hairpin		Unlocked a new item.	Recharge using Lil' Batteries 20 times	358
Hallowed Ground		Unlocked a new item.	Defeat Hush as The Forgotten	398
Hat trick!		Unlocked a new item.	Get a 3-win streak	322
Holy Card		Unlocked a new item.	Defeat Delirium as The Lost	293
Huge Growth		Unlocked a new item.	Increase in size 5 times in a single run via Magic Mushroom, "One makes you larger" pills, XI - Strength, etc.	361
Hushy		Unlocked a new item.	Defeat Hush as Apollyon	315
It's the Key		Unlocked a new item.	Defeat The Lamb without taking Hearts, Coins, or Bombs through the entire run	327
Jaw Bone		Unlocked a new item.	Defeat ??? as The Forgotten	395
Jumper Cables		Unlocked a new item.	Pick up any 2 of the following items/trinkets in a single run: 9 Volt, The Battery, Car Battery, AAA Battery, and Watch Battery ( Any 2 items that have the 'battery' item tag)	367
King Baby		Unlocked a new co-player baby.	Defeat Delirium as ???	286
Lachryphagy		Unlocked a new item.	Collect 10 "Tears Up" items or pills in one run	378
Laz Bleeds More!		Unlocked a new starting item.	Complete Backasswards (challenge #31)	331
Leprosy		Unlocked a new item.	Beat Chapter 3 without taking damage	368
Lil Delirium		Unlocked a new item.	Defeat Delirium for the 1st time	357
Lil Spewer		Unlocked a new item.	Have Isaac die to his own explosion from Ipecac, Bob's Rotten Head, or a Horf! pill	384
Living on the edge		Unlocked a new item.	Complete a Chapter (floors I and II) after Basement, start-to-finish, with only half a Heart total (can use The Lost)	329
Locust of Conquest		Unlocked a new item.	Complete the Boss Rush as Apollyon	314
Locust of Death		Unlocked a new item.	Defeat The Lamb as Apollyon	313
Locust of Famine		Unlocked a new item.	Defeat ??? as Apollyon	312
Locust of Pestilence		Unlocked a new item.	Defeat Satan as Apollyon	311
Locust of Wrath		Unlocked a new item.	Defeat Isaac as Apollyon	310
Maggy Now Holds a Pill!		Unlocked a new starting item.	Complete Aprils Fool (challenge #32)	332
Marbles		Unlocked a new item.	Use 5 Gulp! pills in one run (Placebo uses count)	386
Marrow		Unlocked a new item.	Defeat Mom's Heart or It Lives! on Hard mode as The Forgotten	392
Meconium		Unlocked a new item.	Defeat Ultra Greedier as ???	300
Metronome		Unlocked a new item.	Defeat Ultra Greedier as Eden	303
Mort Baby		Unlocked a new co-player baby.	Defeat Mega Satan as Apollyon	317
Moving Box		Unlocked a new item.	Use Pandora's Box in Dark Room	366
Mr. ME!		Unlocked a new item.	Open 20 Locked Chests	371
Mr. Resetter!		Unlocked a new item.	Reset 7 times in a row Switch PS4 Get a minus 10-win streak	328
Mystery Egg		Unlocked a new item.	Spawn three charmed enemies in the same room	387
Mystery Gift		Unlocked a new item.	Destroy 500 rocks	350
New Area		Unlocked a new area.	Defeat Hush	320
Once More with Feeling!		Unlocked a new item.	Complete a Victory Lap, defeating The Lamb	321
Plan C		Unlocked a new item.	Defeat Ultra Greedier as Lazarus	305
Pointy Rib		Unlocked a new item.	Defeat Satan as The Forgotten	394
Pokey Mans		Unlocked a new challenge.	Defeat Mom's Heart 11 times	279
PONG		Unlocked a new challenge.	Defeat Isaac 5 times	281
Pop!		Unlocked a new item.	Beat Chapter 4 without taking damage	374
RERUN		Unlocked the power of RERUN.	Complete 3 Victory Laps and start a 4th	337
Rotten Penny		Unlocked a new item.	Have 20 Blue Flies at the same time	388
Sack of Sacks		Unlocked a new item.	Defeat Ultra Greedier as Cain	298
Sacrificial Altar		Unlocked a new item.	Take 50 Deals with the Devil	383
Samson Feels Healthy!		Unlocked a new starting item.	Complete Ultra Hard (challenge #34)	334
Scarred Womb		Alt stage to the womb.	Defeat It Lives! 30 times	345
Schoolbag		Unlocked a new item.	Enter 6 Shops in one run	379
Shade		Unlocked a new item.	Defeat Delirium as Judas	285
Silver Dollar		Unlocked a new item.	Defeat Delirium as Cain	284
Sin collector		Unlocked a new item.	Collect every entry in the Bestiary (bugged v190 - Mobs that don't exist in the bestiary are being counted. This allows Sin Collector to be unlocked without a complete bestiary)	324
Slipped Rib		Unlocked a new item.	Defeat Isaac as The Forgotten	393
Smelter		Unlocked a new item.	Defeat Mom's Heart or It Lives! on Hard mode as Apollyon	318
Something wicked this way comes!		Unlocked new bosses!	Defeat ??? as 3 different Characters	346
Something wicked this way comes+!		Unlocked even more bosses!	Defeat ??? as 6 different Characters	347
Sprinkler		Unlocked a new item.	Beat Chapter 1 without taking damage	351
Stem Cell		Unlocked a new item.	Defeat Ultra Greedier as Samson	301
Technology Zero		Unlocked a new item.	Pick up any 2 technology items in a single run ( Any 2 items that have the 'tech' item tag)	369
Telekinesis		Unlocked a new item.	Beat Chapter 2 without taking damage	365
The Forgotten		Unlocked a new character.	It's complicated	390
The gate is open!		Unlocked new enemies!	Defeat The Lamb	348
The Marathon		Unlocked a new item.	Get a 5-win streak in the Daily Challenges (they don't have to be consecutive days, only the runs you play are counted)	336
Trisagion		Unlocked a new item.	Take 25 Angel Rooms items	380
U Broke It!		Unlocked a new item.	Obtain 50 items in a run (duplicate passive items/familiars count towards the total, e.g., multiple Breakfast)	330
Ultra Hard		Unlocked a new challenge.	Defeat ??? or The Lamb. Possession of The Polaroid / The Negative is required, barring getting to Dark Room through a Sacrifice Room. Defeat Mega Satan and unlock The Negative	280
Void		Unlocked a new item.	Defeat Delirium as Apollyon	295
Wooden Cross		Unlocked a new item.	Sleep in a bed	359
ZIP!		Unlocked a new item.	Defeat The Lamb in under 20 minutes	326